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Frequently Asked Questions

AtlantiCare Regional Medical Center Bills

Here you find answers to our most frequently asked questions. Click on the question to read our response. If you do not find the information you need here, please contact us.

Questions:

Why can I only pay my ARMC bill online?

Do you offer payment arrangements?

Why do I receive separate bills from the hospital and from the physician?

Will you bill my primary and secondary insurance carriers?

Is there any help available that allows me to better understand my billing statement?

Why did my insurance carrier deny the claim?

Why did the insurance carrier only pay part of my bill?

Why do I need to call the insurance carrier if they do not pay the bill?

I belong to a managed care plan. What should I do before coming to AtlantiCare Regional Medical Center?

What does "In-network" and "out-of-network" mean?

How do I know if my health plan requires a referral or pre-certification for a service?

What should I do when I relocate or change my address and/or telephone number?

What should I do when my insurance carrier has changed?

What should I do if my health plan includes AtlantiCare as a participating provider, but I receive an explanation of benefits stating I am out of network?

When can I expect to receive a bill from ARMC?

I received a questionnaire from my insurance company. It is asking me if someone else is liable for my bill. What does that mean and do I really have to complete this form?

I received a questionnaire from my insurance company. They are asking me about ‘coordination of benefits’ information. What does that mean? Do I really have to complete and return the form?

What happens if I don’t agree with my insurance company on their determination of not covering my bill? Do I still have to pay the Hospital?

Answers

Q: Why can I only pay my ARMC or Surgery Center bill online?

A: At this time, ARMC and the AtlantiCare Surgery Center is the only AtlantiCare affiliate equipped to accept online payments. In the future, we plan to add online billing for other AtlantiCare services.

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Q: Do you offer payment arrangements?

A: Payment in full is requested upon receipt of your bill. However, we will be happy to work with you to resolve your balance if you are unable to make a full payment immediately. For more information, please contact our billing department at (609) 407-2550.

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Q: Why do I receive multiple bills for facility, physician, anesthesia and laboratory services?

A: There are many services at ARMC which may have a professional fee associated with them. For example:

  • If you come to the ARMC for an x-ray, you can expect to see a bill or statement from Radiology. Radiology Associates are the physicians who read and interpret your x-rays. In reality, you may never seen the radiologist who is billing you, but he or she interpreted your x-ray and reported those findings back to your physician who ordered the test.

It is often confusing to patients if they know they were not physically present on campus on a certain date for which they are receiving a bill. Usually, the answer is that, when you were a patient in your doctor’s office, he or she obtained a blood or urine specimen which was then sent to the hospital laboratory for processing. For those services, you will receive a bill. Examples of these types of situations include:

  • Women who visit their gynecologist and have a Pap smear.
  • Patients who visit the dermatologist and have a skin lesion removed.
  • Patients who visit their primary care doctor for a throat culture.

To view an explanation of bills you may receive, click here.

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Q: Will you bill my primary and secondary insurance carriers?

A: Yes, as a courtesy to our patients, AtlantiCare will submit the bill to your insurance carrier and will assist if problems arise. You are requested to supply the pertinent billing information that the insurer may require. For Example: a referral for the specific date of service.

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Q: Is there any help available that allows me to better understand my billing statement?

A: Yes, our interactive tool, Understanding Your Bill, helps to explain the various section of your bill. You may also wish to contact Customer Service by phone.


Q: Why did my insurance carrier deny the claim?

A: Your insurance carrier may deny the claim for one or more reasons. It is always best to call member services at your insurance carrier to discuss your account. Some popular denial reasons are:

      • You were not covered by your plan on the date of service.
      • The patient cannot be identified.
      • The primary physician did not issue a referral.
      • The service was not authorized.
      • The service you received was out of network.
      • The balance is due to the patient’s deductible, co-insurance and/or co-pay.
      • The account denied as “other insurance carrier is primary”

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Q: Why did the insurance carrier only pay part of my bill?

A: Most insurance plans require you to pay a deductible and/or co-insurance. In addition, you could be responsible for non-covered services and co-pays for some services such as those rendered within the emergency room and for specialist visits. You may also wish to call member services at your insurance carrier for more information.

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Q: Why do I need to call the insurance carrier if they do not pay the bill?

A: You are ultimately responsible for the total bill or any portion of the bill that your insurance carrier did not pay. The AtlantiCare billing professionals will make every effort to resolve the account balance with your insurance carrier in a timely manner. Occasionally, we are unable to resolve the issue with your carrier and will need your assistance.

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Q: I belong to a managed care plan. What should I do before coming to AtlantiCare?

A: The best patient is an informed patient. Read your insurance booklet to be sure you are following all the guidelines for referral and authorizations, or call member services at your insurance carrier for assistance. Failure to follow your plan requirements could result in greater out-of-pocket expenses for you. Your primary care physician plays a very important role in this process. If you receive a verbal authorization number, please provide this information at registration.

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Q: What does "In-network" mean?

A: If you receive your healthcare services from a hospital, physician or other health provider that participates in your health plan, they care considered “in-network”.

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Q: How do I know if my health plan requires a referral or pre-certification for a service?

A: Your benefit booklet or provider directory should provide this information for you. If not available, call member services at your insurance carrier and they should be able to help you.

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Q: What should I do when I relocate or change my address and/or telephone number?

A: When your personal information changes, you should always notify your medical providers of the change.

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Q: What should I do when my insurance carrier has changed?

A: When you experience any changes regarding your health insurance, you should contact all the providers that offered medical services to you.

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Q: What should I do if my health plan includes AtlantiCare as a participating provider, but I receive an explanation of benefits stating I am out of network?

A: Consult your health plan’s member services unit directly.

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Q: When can I expect to receive a bill from the Surgery Center?

A: Your type of insurance will affect when you actually receive a bill from the Surgery Center. Typically, you will receive a bill after your insurance company has processed the bill with either a payment or rejection. There might be times when your insurance has not responded to our request for payment. You may be asked to become actively involved in resolving the open balance.

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Q: I received a questionnaire from my insurance company. It is asking me if someone else is liable for my bill. What does that mean and do I really have to complete this form?

A: Yes. You must complete this form or your insurance company will not pay your bills. Sometimes if an insurance company notices that the diagnosis on the bill is the result of an accident, the insurance company will want more information to determine if someone else or another insurance company should be paying the bill.

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Q: I received a questionnaire from my insurance company. They are asking me about ‘coordination of benefits’ information. What does that mean? Do I really have to complete and return the form?

A: Yes. Any request for information from your insurance company is very important. Coordination of benefits means that your insurance company thinks you may be covered by another insurance plan in addition to their coverage. By sending you the questionnaire, they are trying to determine which insurance is responsible for paying What happens if I don’t agree with my insurance company on their determination of not covering my bill? Do I still have to pay ARMC?

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Q: What happens if I don’t agree with my insurance company on their determination of not covering my bill? Do I still have to pay the Surgery Center?

A: Yes. You are still responsible to pay the ARMC bill even if you disagree with your insurance company on its determination of nonpayment for the service. At the time of each service, our patients sign a document, which indicates that, upon receipt of a bill from ARMC, they will pay the bill. However, you are empowered to pursue your disagreement with your insurance company through a formal grievance process. Most insurance companies have outlined the grievance procedure in your benefits pamphlet.

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